News & Analysis as of

Blue Cross

Manatt on Health Reform: Weekly Highlights - May 2017 #5

CBO says the House repeal and replace bill could destabilize the individual insurance market in some states; Indiana posts a work requirement amendment to its Medicaid expansion waiver application; and states allow insurers...more

For Health Insurers, Court Decisions Continue to Complicate Risk Corridors Program Payments

by Faegre Baker Daniels on

For health insurers concerned about when they may receive government payments through the Affordable Care Act’s (ACA) risk corridor program, court decisions have provided little clarity. An April 18 decision by Judge Griggsby...more

Blues Defeat Antitrust Claim by Heart Monitoring Device Maker

by Baker Ober Health Law on

On April 3, Judge Eduardo Robreno, District Judge for the Eastern District of Pennsylvania, granted judgment to a collection of insurer defendants in an antitrust conspiracy case brought against them by heart monitoring...more

Health Care Newsmakers J. Bradley Wilson & Michael M. Dudley

by Williams Mullen on

We are fortunate to have two industry leaders, J. Bradley Wilson, President and CEO, Blue Cross and Blue Shield of North Carolina, and Michael M. Dudley, President and CEO of Optima Health and Senior Vice President of Sentara...more

Proposals to Cap State Medicaid Funding: Massachusetts Considerations - Prepared for the Massachusetts Coalition for Coverage and...

In a new chart pack commissioned by the Blue Cross Blue Shield of Massachusetts Foundation for the Massachusetts Coalition for Coverage and Care, Manatt Health provides an overview of proposals to cap federal Medicaid funding...more

News from the Vermont State House - An analysis from DRM's Government & Public Affairs Team - February 2017 #3

by Downs Rachlin Martin PLLC on

Act 188 Plans On Hold as New Chemical Bill is Introduced - Nearly three years after the legislature passed a law to regulate children’s products containing chemicals of high concern, a web site intended to inform the...more

Litigation Alert: The Third Circuit Holds That Allegations That Personal Information Was Improperly Disclosed in Violation of the...

by Fenwick & West LLP on

Last week, the Third Circuit held that allegations of the unauthorized disclosure of personal information in violation of the Fair Credit Reporting Act (FCRA) constituted a de facto injury sufficient to confer standing at the...more

Blue Cross Plans Effort to Escape MDL Antitrust Case on Jurisdictional Grounds Fails

by Baker Donelson on

On December 21, District Judge David Proctor (N.D. Alabama) denied an attempt by nine Blue Cross plans to escape the In re Blue Cross Blue Shield Antitrust Litigation. Finding that the Blues (Mississippi, Triple-S Salud...more

Your Stipulated Protective Order May Not Provide As Much Protection As You Expect

by Latham & Watkins LLP on

In a growing number of courts, a negotiated protective order entered for discovery purposes will not protect litigants’ confidential information from public disclosure. Stipulated protective orders are commonly used...more

Big Summary Judgment Win for Hospital Defending $300M Exclusive Dealing Antitrust Suit

by Mintz Levin on

After fending off a motion for judgment on the pleadings in March 2015, a small hospital in Peoria, Illinois lost on summary judgment in its $300 million antitrust suit alleging illegal exclusive dealing and attempted...more

Employee Benefits Developments - August 2016

by Hodgson Russ LLP on

The Employee Benefits practice group is pleased to present the Benefits Developments Newsletter for the month of August, 2016. ...more

3.3 Million Health Records Breached by Business Associate Newkirk

Newkirk Products Inc., which provides ID cards and management services for healthcare organizations, including multiple Blue Cross Blue Shield organizations, has announced that it has discovered that its computer system was...more

Plaintiffs Cannot Bring Data Breach Lawsuits Without Evidence That Information Will Be Used To Harm

by Ballard Spahr LLP on

The latest development in how American courts will handle the standing question for data breach class actions came last week when the U.S. District Court for the District of Columbia dismissed for lack of standing a putative...more

Manatt on Health Reform: Weekly Highlights - August 2016

Oregon’s hospitals see improved financial performance following the ACA; CMS denies Indiana’s request for an additional lockout period in the Medicaid expansion program; and a new Manatt Health report details Medicaid funding...more

Manatt on Health Reform: Weekly Highlights - July 2016

Massachusetts extends coverage of Hepatitis C treatments and New Hampshire extends substance use disorder coverage to more Medicaid enrollees; Alaska’s Medicaid expansion now moves ahead uncontested; and CMS reports...more

Blue Cross Blue Shield of Oklahoma Escapes Antitrust Action by Disgruntled Provider

by Baker Donelson on

On June 8, District Judge Claire Eagan (N.D. Okla.) dismissed the Blue Cross Blue Shield Association (BCBSA) and Blue Cross Blue Shield of Oklahoma (BCBSO) from an antitrust suit brought by a disgruntled health care provider,...more

Maryland Co-Op Claims Risk Adjustment Formula Discriminates Against Smaller Insurers

Maryland’s Evergreen Health Cooperative has filed for an injunction against the federal government to halt payment by the Consumer Operated and Oriented Plan (co-op) of the $22 million it owes to CareFirst BlueCross...more

Update – More Risk Corridors Lawsuits Filed

by Freeborn & Peters LLP on

To update our recent post, “Exchange Players File ACA Lawsuits Against CMS,” two new suits were filed by Qualified Health Plan (QHP) issuers selling coverage on the Affordable Care Act (ACA) exchanges. As described in our...more

Coordinating your reimbursement and regulatory strategies for a successful product launch

by Dentons on

Ensuring appropriate third-party reimbursement for a new pharmaceutical or medical product involves an intricate interplay of considerations. There is no doubt that government and private payers have been under increasing...more

What You Say in Your SPD About Claims Processing Makes a Difference

Employers who self fund their medical plans often have contracts with their third party administrators about claims processing. Some of those contracts provide that the claims processor has discretion to decide claims; others...more

Health Law Insights Newsletter - Issue 8 - April 2016

by McCarter & English, LLP on

McCarter & English, LLP’s Health Care Group presents Issue 8 of the Health Law Insights, which discusses the latest legal issues in the health care industry. NATIONAL - New Payment Model for Part B Drugs Proposed -...more

None Of Your Business: Eleventh Circuit Enters A Gray Area For Contract Liability Exclusions

by Carlton Fields on

Businesses have responsibilities; they buy liability insurance to cover losses that arise if they fail to perform them all. Businesses also “assume” responsibilities under contracts; those responsibilities are typically...more

Sullivan & Worcester Files Amicus Brief on Behalf of Major Brand Companies Supporting EPA’s Clean Power Plan

by Sullivan & Worcester on

WASHINGTON, DC – April 1, 2016 – Sullivan & Worcester today filed an amicus brief on behalf of four global brand companies with significant energy footprints in nearly every state in the country in the U.S. Court of Appeals...more

Collecting Another Supreme Win for ERISA Preemption - Court in Gobeille Invalidates Vermont Data Collection Law

by Dechert LLP on

The U.S. Supreme Court decided the case of Gobeille v. Liberty Mutual Insurance Co. last week, in which the Court invalidated a Vermont health care data collection law as being preempted by the Employee Retirement Income...more

The New Face of Commercial Crime - Cybersecurity Risks for Companies and their Directors

by Bennett Jones LLP on

The threat of commercial crime against companies is transforming. Technology has created new and innovative ways for fraudsters to exploit individuals and companies through cyber attacks. This new face of fraud can give rise...more

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